A person suffering injuries to his back or neck generally requires some degree of immobilization until he receives full medical attention at a hospital. Depending upon the location of the accident and any resulting debris, the individual may require two stages of such immobilization. The first stage precludes motion during the extrication from his immediate predicament as often occurs in the case of automobile accidents.
The second immobilization places the patient in a condition suitable for transportation to a medical facility. In this position, the patient lies immobile upon a flat, rigid, stiff structure running the entire length of his body.
The structure employed in first immobilizing stage, however, involves a board extending only from the patient's head down to the region of his hips. Known as a torso-board, it generally includes openings to accomodate straps which will secure the patient to the board with his knees bent towards his chest.
Such a board appears generally at 10 in FIGS. 1 through 3 of the drawings and includes the large rectangular area 11 which supports an injured person's back. The smaller region 12, integral with one side of the large area 11, performs a similar function for a person's neck by immobilizing his head. The small section 12 includes the semicircular cutouts 13 along both sides. As shown in FIG. 1, the strap 14 fits inside a cutout 13 on either side of the section 12. Tightening the cup 15 onto the individual's chin keeps the head against the board's section 12 and prevents motion.
The auxiliary strap 16 holds the patient's wrists together. Moreover, the small area 12 also includes the opening 17 at its top to facilitate carrying the board either with or without a patient on it.
The board's large area 11 includes the openings 20 and 21 at its bottom coinciding with the patient's pelvic or hip area. Further, a pair of lateral openings 22 and 23 appear in the region around the patient's shoulders. Lastly, the openings 24 and 25 occur at the top of the larger portion 11 and generally fall slightly above the patient's shoulder. The two shoulder openings 22 and 24 on one side and the openings 23 and 25 on the other side permit different orientations of the staps to the patients they retain. These accomodate differences in the heights and sizes of the patients as well as the types of injury incurred. The latter openings 22 and 23 also facilitate a patient's subsequent placement on a full-length board as discussed below.
Many emergency medical units currently possess torso boards similar to that shown at 10. They may have purchased these, or even fashioned them out of sheets of plywood.
The use of these boards, however, requires some form of straps to retain the patient in an immobilized condition. Previously, straps similar in construction to safety belts for automobiles and airplanes performed the function. Specifically, they assumed the form of nine-foot long straps with a metal buckle at one end and a metal tongue near the other end. In operation, the technician extended the belt across the back of the board; passed its ends through openings at opposite corners; and latched together the tongue and buckle with the lower portion of the strap wrapped around the leg to immobilize the pelvic region. Two belts utilized in this fashion normally provided sufficient restraint.
The use of the straps, however, suffers from several shortcomings. First its application may represent a difficult, inconvenient, and perhaps injurious task. Applying the straps requires access to the back of the board. The patient's predicament may prevent the application of the straps before the placement of the board adjacent to the patient. Consequently, the proper threading of the straps through the holes and around the back may produce substantial movement of both the board and the patient. This motion can seriously and deleteriously affect the patient's condition.
Furthermore, this type of strap admits of only one type of adjustment. Specifically, the overall length may undergo alteration. However, this can only occur by separating the buckling, moving the metal tongue to a different position on the strap, and rebuckling the strap. Upon its unbuckling, though, all immobilizing tension from the strap disappears; the two free ends cannot restrain the patient whatsoever. Furthermore, the adjustment may not proceed facilely, since part of the strap wraps around the patient's leg and a further part goes behind the board; the slack may not readily disappear.
Moreover, the buckle used to hold the strap together itself involves substantial bulk and weight. It can bounce against the chest or, during the patient's handling, press against him, producing bruises and further injuries.
Moreover, extricating the patient from his situation requires moving him and the board both relative to the earth. The process may also effect a shift in the patient's weight relative to the board and the straps. This can result in the straps becoming loose and not providing the requisite immobility. Tightening them involves moving the board back and forth to remove slack in the back again as well as attempting to change the strap position around the legs. Once again, moreover, the ends of the strap may have to unbuckle from each other to allow adjustment of their effective length.
Subsequent to his removal from his immediate predicament, the patient should normally assume a completely flat position on a full-length board as in FIG. 4. The previous straps, however, interfere with the torso board 10 lying flat and motionless upon the full-length board 30. Consequently, placing the patient upon the latter requires the complete disengagement of the straps from the patient while on the torso board 10. Further deleterious motion results as the torso board and the patient are then placed on the long board 30 or the patient alone shifted to it.
Lastly, placing the patient on the full-length board 30 requires unfastening the straps from his legs so that they may lay flat. Releasing the buckles that hold the straps together, however, simply permits the legs to drop from their bent position. This drastic motion, unless very carefully guarded against, will considerably shock the system and aggravate the injuries. Preventing this undesired motion requires two medical personnel; one must control the motion of the legs while the other unbuckles the straps.